Home Healthcare Program Among Adults Aged 50 and Older: A RE-AIM Framework Evaluation Using 3-Year Real-World Data

Home healthcare is a widely adopted health policy to address the needs of aging societies. This study examined Taiwan's home healthcare policy as a case example, assessing its implementation through the five dimensions of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Taiwan's home healthcare policy, launched in 2016 as the "Integrated Home-Based Medical Care" (iHBMC) program, is reimbursed by the National Health Insurance. The study utilized data from the National Health Insurance Research Database and publicly available government sources. A total of 15,761 adults aged 50 years and above in the iHBMC program during its first year were identified, with 16% receiving home-based primary care (S1) and 84% receiving home-based advanced care (S2) (Reach). Prescriptions for chronic diseases and emergency department visits were significantly decreased among S1 and S2 patients after the iHBMC program (Effectiveness). Among all institutions delivering home healthcare, the majority were clinics (74%), followed by home nursing care agencies (18.3%) and hospitals (7.5%) (Adoption). Continuity of care was higher in S1 than in S2 (Implementation). More than 70% of participants engaged in the program for more than 6 months (Maintenance). These findings suggest the iHBMC program is feasible, improves healthcare utilization, and reduces hospital burden.